Annals of Diagnostic Pathology最新文献

{"title":"Inflammatory myofibroblastic tumors of the skin and mucosal sites: A clinicopathological and molecular analysis of 3 cases with emphasis on differential diagnosis","authors":"Danting Xiong ,&nbsp;Xiaona Yin ,&nbsp;Yongli Gan ,&nbsp;Wenjuan Gan ,&nbsp;Xiao Cheng ,&nbsp;Ming Zhao","doi":"10.1016/j.anndiagpath.2025.152569","DOIUrl":"10.1016/j.anndiagpath.2025.152569","url":null,"abstract":"<div><div>This study presents three molecularly confirmed cases of <em>ALK</em>-rearranged inflammatory myofibroblastic tumors (IMTs) occurring in superficial locations, demonstrating their rarity, clinicopathologic heterogeneity and diagnostic complexity. The series comprised tumors involving oropharyngeal mucosa, dermal/subcutaneous tissue of the forearm, and tongue mucosa. Histopathological evaluation revealed characteristic proliferations of spindle-to-ovoid cells arranged in fascicular patterns within variably collagenous to myxoid stroma, accompanied by chronic inflammatory infiltrates. Notable morphologic variations included: (1) rhabdomyoblastic differentiation evidenced by rhabdoid morphology and desmin, MyoD1 and myogenin co-expression in one case, histologically overlapping with inflammatory rhabdomyoblastic tumor; and (2) histiocytoid morphology featuring microvesicular cytoplasm in another case, resembling non-neural granular cell tumor. All cases exhibited strong diffuse cytoplasmic ALK immunoreactivity. Molecular profiling identified <em>DCTN1</em>(exon26)::<em>ALK</em>(exon20) fusions in two cases and <em>TIMP3</em>(exon1)::<em>ALK</em>(exon19) fusion in the lingual lesion, the latter corroborating established associations between <em>TIMP3</em>::<em>ALK</em> fusions and head/neck mucosal sites. With follow-up periods of 4–30 months post complete resection, all patients remained disease-free. These findings expand the recognized morphologic spectrum of cutaneous and superficial mucosal <em>ALK</em>-rearranged IMTs while underscoring the indispensable role of integrated histopathologic and molecular pathologic evaluation in differentiating these neoplasms from their histologic mimics, such as inflammatory rhabdomyoblastic tumor, non-neural granular cell tumor, and epithelioid fibrous histiocytoma/superficial <em>ALK</em>-rearranged myxoid spindle cell neoplasm.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152569"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological variants of head and neck squamous cell carcinomas: A multicenter study in Latin America","authors":"Heitor Albergoni Silveira ,&nbsp;Karina Helen Martins ,&nbsp;Ana Lia Anbinder ,&nbsp;Thais Aguiar Santos ,&nbsp;Elton Fernandes Barros ,&nbsp;Pollianna Muniz Alves ,&nbsp;Cassiano Francisco Weege Nonaka ,&nbsp;Ana Terezinha Marques Mesquita ,&nbsp;Matheus Henrique Lopes Dominguete ,&nbsp;Rafael Rodrigues Dias ,&nbsp;Katya Pulido Díaz ,&nbsp;Florence Juana Maria Cuadra-Zelaya ,&nbsp;Bruno Augusto Benevenuto de Andrade ,&nbsp;Elaine Maria Sgavioli Massucato ,&nbsp;Andreia Bufalino ,&nbsp;Thales Peres Candido Moreira ,&nbsp;Anderson Tangerino Ferreira da Silva ,&nbsp;Ana Carla Campos ,&nbsp;Magdalena Raquel Torres Reyes ,&nbsp;Mariângela Ottoboni Brunaldi ,&nbsp;Jorge Esquiche León","doi":"10.1016/j.anndiagpath.2025.152565","DOIUrl":"10.1016/j.anndiagpath.2025.152565","url":null,"abstract":"<div><div>Histopathological variants of head and neck squamous cell carcinoma (HNSCC) are uncommon and account for approximately 5–15 % of all HNSCC cases. Owing to their heterogeneous clinicopathological characteristics, a correct diagnosis can be challenging. We aimed to analyze the clinicopathological, histochemical (HC), immunohistochemical (IHC), and in situ hybridization (ISH) findings of HNSCC variants in a Latin American population. In total, 1415 HNSCCs were retrospectively evaluated in accordance with the 2023 World Health Organization criteria. Sixty-six (4.6 %) HNSCC variants were identified, including verrucous carcinoma (VC, <em>n</em> = 21), basaloid SCC (BSCC, <em>n</em> = 13), spindle cell SCC (SCSCC, <em>n</em> = 8), adenosquamous carcinoma (ASC, <em>n</em> = 6), clear cell SCC (CCSCC, <em>n</em> = 4), cuniculatum carcinoma (CC, n = 4), lymphoepithelial carcinoma (LC, <em>n</em> = 3), papillary SCC (PSCC, <em>n</em> = 2), acantholytic SCC (ASCC, n = 2), pigmented SCC (PigSCC, n = 2), and carcinoma with rhabdoid phenotype (CRP, <em>n</em> = 1). Histomorphology, supported by IHC (mainly p53 and Ki-67), allows the diagnosis of most cases of VC, CC, PSCC, ASCC, and PigSCC. Mutant-type p53 pattern is common in BSCCs. SCSCC diagnosis requires IHC to highlight the epithelial phenotype in most cases, almost all of which exhibit a mutant-type p53 pattern. Human papillomavirus-associated BSCC and SCSCC are rare. HC analysis supported by IHC is relevant for most ASC and CCSCC diagnoses. Owing to the inflammatory component, IHC may be crucial for highlighting LC cells, with potential Epstein–Barr virus infection. CRP diagnosis relies on IHC and ISH findings in strict clinical correlation. Therefore, detailed clinicopathological characterization of HNSCC variants is fundamental because it provides valuable data with diagnostic, therapeutic, and prognostic impacts.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152565"},"PeriodicalIF":1.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of surgical technique on histopathological specimen quality: Transurethral resection of the prostate versus bipolar enucleation of the prostate","authors":"Onur ERTUNÇ ,&nbsp;Taylan OKSAY ,&nbsp;Enes Emre AŞMAN ,&nbsp;Kadir ERYILMAZ","doi":"10.1016/j.anndiagpath.2025.152564","DOIUrl":"10.1016/j.anndiagpath.2025.152564","url":null,"abstract":"<div><div>This study examines the effects of Transurethral Resection of the Prostate (TURP) and Bipolar Enucleation of the Prostate (BipoLEP) techniques on the histopathological quality of specimens in benign prostatic hyperplasia surgery. A retrospective analysis was conducted on 200 patients (100 TURP, 100 BipoLEP) treated at a single center between January 2021 and January 2023. Specimens were systematically evaluated for artifacts, including fragmentation, thermal, telescoping, sectioning, processing, and staining artifacts. The relationship between surgical technique and artifact types was analyzed using independent samples <em>t</em>-tests, while pathological diagnoses were compared using the chi-square test. Additionally, a pilot group of 10 patients (5 TURP, 5 BipoLEP) underwent immunohistochemical analysis with p63, p27, and androgen receptor to assess antigen preservation. Fragmentation was significantly higher in the BipoLEP group (87 %) compared to the TURP group (6 %) (<em>p</em> &lt; 0.001). Conversely, thermal artifacts were notably more frequent in TURP specimens (97 %) than in BipoLEP (22 %) (<em>p</em> &lt; 0.001). Sectioning artifacts were observed more often after TURP (24 %) compared to BipoLEP (4 %) (p &lt; 0.001), while telescoping artifacts were also more prevalent in BipoLEP (90 %). No significant differences were detected between groups regarding processing or staining artifacts. Both techniques provided comparable diagnostic adequacy and rates of incidental prostate cancer detection. In conclusion, the choice of surgical technique substantially influences the type and frequency of histological artifacts. Therefore, awareness of the surgical method is vital for pathologists to ensure accurate interpretation and optimal patient management.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152564"},"PeriodicalIF":1.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of gastrointestinal biopsies with two-slide serial sections: Analysis of 1715 cases with emphasis on clinical impact","authors":"Nuray Tezcan ,&nbsp;Rohat Esmer ,&nbsp;Gulbanu Canbaloglu ,&nbsp;Gokhan Baysoy ,&nbsp;Pınar Korkmaz ,&nbsp;Merve Senturk ,&nbsp;Serdar Balci ,&nbsp;Burcu Saka","doi":"10.1016/j.anndiagpath.2025.152566","DOIUrl":"10.1016/j.anndiagpath.2025.152566","url":null,"abstract":"<div><div>Although serial sectioning may improve diagnostic yield, no standardized protocol currently exists for endoscopic gastrointestinal (GI) biopsies. The aim of this study was to determine whether examining two serially sectioned slides from each biopsy specimen increases the detection of clinically relevant histopathological findings. In this prospective study, 1715 endoscopic GI biopsy specimens were evaluated using a two-slide serial sectioning approach, with eight consecutive sections per slide. A diagnostic discrepancy was defined as the presence of a histopathological finding on one slide that was absent on the other, thereby representing slide-to-slide variability in detection. Each biopsy specimen was treated as an individual case for serial sectioning and diagnostic assessment purposes, regardless of patient identity, as the study focused on per-sample diagnostic variability. Diagnostic discrepancies between slides were found in 2.2 % of cases, with 1.4 % deemed clinically significant. These included both gain of additional findings on the second slide and loss of findings that were present only on the first slide. Intestinal metaplasia was the most frequently observed clinically relevant finding, particularly in antral biopsies. Importantly, no additional malignancies were identified on second slides, and none of the biopsy-related variables showed a significant association with diagnostic discrepancies. Overall, these findings suggest that, while infrequent, diagnostic discrepancies introduced by serial sectioning may have meaningful clinical implications—particularly in detecting preneoplastic conditions such as intestinal metaplasia in the antrum.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152566"},"PeriodicalIF":1.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Letter to the editor: MTAP and p16 as immunohistochemical surrogates of CDKN2A/B homozygous deletion in central nervous system tumors: A multicentre Italian experience.”- Reply","authors":"Serena Salzano ,&nbsp;Giuseppe Broggi","doi":"10.1016/j.anndiagpath.2025.152563","DOIUrl":"10.1016/j.anndiagpath.2025.152563","url":null,"abstract":"","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152563"},"PeriodicalIF":1.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histomorphology and utility of CK17, p53 dual stain with CK 13 in the diagnosis of differentiated vulvar intraepithelial neoplasia","authors":"Bushra K. Altarawneh ,&nbsp;M. Ruhul Quddus ,&nbsp;Kamaljeet Singh ,&nbsp;C. James Sung ,&nbsp;Shivali Marketkar","doi":"10.1016/j.anndiagpath.2025.152561","DOIUrl":"10.1016/j.anndiagpath.2025.152561","url":null,"abstract":"<div><div>Differentiated vulvar intraepithelial neoplasia (dVIN) is a known precursor for HPV-independent vulvar squamous cell carcinoma (VSCC). Diagnosis of dVIN can be challenging, and immunohistochemistry (IHC) may be a useful aid in this setting. A mutated pattern of p53 staining is associated with dVIN. This retrospective study evaluated the histological features and immunohistochemical utility of p53/Cytokeratin 17 (CK17) dual staining and cytokeratin 13 (CK13) staining in dVINs. At our institution, the diagnosis of dVIN is primarily based on morphology, and p53 stain is not routinely performed, especially in cases with concurrent invasive carcinoma or in recurrences. Thirty-two cases of dVIN identified from the pathology archives included 21 cases with p53 mutations and 11 cases without p53 mutations. Fourteen cases were biopsies. The staining patterns of CK17 and CK13 were compared in p53-mutated and non-mutated dVINs. p53/CK17 dual stain was used, which helped assess aberrant CK17 staining patterns adjacent to the mutated p53 patterns. Of the p53-mutated dVINs, 18/21(85.7 %) cases showed full-thickness CK17 staining. Of the remaining 11 cases with p53 wild-type staining, 5 cases showed full-thickness CK17 staining (45 %). Of the p53-mutated dVIN cases, 8/21 (38.09 %) showed full-thickness CK13 staining. Only 2/21 (9.5 %) showed loss of CK13 staining, as seen in oral dysplasia. Amongst dVINs with wild-type p53 staining, 50 % showed full-thickness CK13 staining. None of the lichen sclerosus cases showed full-thickness staining for CK13. The utility of CK13 staining in dVIN has been studied in only one previous study. A Panel consisting of p53, CK13, and CK17 antibodies may aid in increasing the accuracy of dVIN diagnosis, especially when a full-thickness staining pattern of CK13 and CK17 is noted. Further investigation of dVINs with full-thickness CK13 staining in a larger cohort is needed to confirm the results.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152561"},"PeriodicalIF":1.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: “p63 immunohistochemical expression in tumor cells of high-grade invasive breast carcinomas on core biopsy: a potential diagnostic pitfall”","authors":"Sanhia Maheshwari","doi":"10.1016/j.anndiagpath.2025.152562","DOIUrl":"10.1016/j.anndiagpath.2025.152562","url":null,"abstract":"","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152562"},"PeriodicalIF":1.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of minimally invasive tissue sampling (MITS) for cause of death determination up to 72 h postmortem","authors":"Juan Carlos Hurtado ,&nbsp;Natalia Rakislova ,&nbsp;Núria Peñuelas ,&nbsp;Carla Carrilho ,&nbsp;Fabiola Fernandes ,&nbsp;Luisa Jamisse ,&nbsp;Mireia Navarro ,&nbsp;Alba Morató ,&nbsp;Laia Diez-Ahijado ,&nbsp;Isaac Casas ,&nbsp;Lucilia Lovane ,&nbsp;Jessica Navero ,&nbsp;Cesaltina Lorenzoni ,&nbsp;Rosauro Varo ,&nbsp;Assucena Guisseve ,&nbsp;Lorena Marimon ,&nbsp;Anelsio Cossa ,&nbsp;Inacio Mandomando ,&nbsp;Lia Sisuashvili ,&nbsp;Jordi Vila ,&nbsp;Jaume Ordi","doi":"10.1016/j.anndiagpath.2025.152559","DOIUrl":"10.1016/j.anndiagpath.2025.152559","url":null,"abstract":"<div><div>Minimally invasive tissue sampling (MITS) is a postmortem technique that involves percutaneous needle sampling of key organs and fluids, offering a practical alternative to complete autopsy for determining cause of death (CoD), a critical factor in reducing mortality. In low- and middle-income settings, autopsies are rarely performed, particularly in the first hours after death. To assess the impact of postmortem interval (PMI) on MITS diagnostic performance, we compared CoD determinations from repeated MITS procedures at different PMIs in the same individuals and analyzed changes in histological and microbiological findings over time. We conducted serial MITS at 24, 48, and 72 h after death in nine adults who died at Maputo Central Hospital, Mozambique, between June 2017 and January 2018. The process included thorough histological and microbiological analyses.</div><div>Results showed that MITS maintained consistent diagnostic accuracy across all PMIs. While histological findings showed minor changes over time, these did not significantly affect CoD determination. Microbiological analyses revealed a substantial increase (<em>p</em> &lt; 0.0001) in <em>Enterobacteriaceae</em> isolation with longer PMIs, whereas fungal and parasitic detection remained stable, and viral isolations declined. These findings highlight that MITS remains reliable for postmortem diagnosis even when performed up to 72 h after death, offering crucial utility in settings where immediate autopsies are unfeasible.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152559"},"PeriodicalIF":1.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In reply: SOX10 and TRPS1 in triple-negative breast cancer: Promise, pitfalls, and the need for broader validation","authors":"Shaimaa Abdelraouf Elgohary","doi":"10.1016/j.anndiagpath.2025.152558","DOIUrl":"10.1016/j.anndiagpath.2025.152558","url":null,"abstract":"","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152558"},"PeriodicalIF":1.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of SSTR2A, ATRX, and clusterin immunohistochemical expression in high-grade gastroenteropancreatic neuroendocrine neoplasms","authors":"Yutong Fu,&nbsp;Shixuan Du,&nbsp;Saisai Nie,&nbsp;Qiqi Shao,&nbsp;Wenli Guo,&nbsp;Yuehong Li ,&nbsp;Lei Lou","doi":"10.1016/j.anndiagpath.2025.152560","DOIUrl":"10.1016/j.anndiagpath.2025.152560","url":null,"abstract":"<div><div>High-grade gastroenteropancreatic neuroendocrine neoplasms (NENs) are a heterogeneous group of rare tumors, classified into well-differentiated neuroendocrine tumors grade 3 (G3 NETs) and poorly differentiated neuroendocrine carcinomas (NECs). Distinguishing G3 NETs from NECs is challenging. We aimed to summarize the clinicopathologic characteristics of G3 NETs; examine the expression of somatostatin receptor 2A (SSTR2A), clusterin, and ATRX in G3 NETs and NECs; and explore the diagnostic and prognostic value of combining these markers for the differential diagnosis of G3 NETs. Data on 87 patients with high-grade NENs (G3 NETs: 18, NECs: 69) were retrospectively collected and classified according to the 5th edition of the WHO Classification of Digestive System Tumors. Immunohistochemistry was performed for SSTR2A, ATRX, and clusterin. Relationships between protein expression and clinicopathological features were analyzed. The diagnostic significance of combining these markers was assessed using receiver operating characteristic curves. SSTR2A protein expression, loss of ATRX expression, and positivity rate for clusterin were significantly higher in G3 NETs than in NECs [77.8 % (14/18) vs. 42.0 % (29/69), 61.1 % (11/18) vs. 33.3 % (23/69), and 77.8 % (14/18) vs. 30.4 % (21/69), respectively]. ATRX expression loss was significantly more common in large-cell than small-cell NECs. In differentiating G3 NETs from NECs, the area under the curve of the combined diagnosis using SSTR2A, clusterin, and ATRX was significantly higher than the individual values (0.833 vs. 0.679, 0.737, and 0.639, respectively). Combining SSTR2A, clusterin, and ATRX improves diagnostic accuracy. Our immunohistochemical assessment provides diagnostic insights for distinguishing G3 NETs from NECs.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152560"},"PeriodicalIF":1.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}